Cigna v Empire BlueCross BlueShield PPO plans

[niccig]

It's that time of year, and DH's company is changing Health Insurance yet again. We all liked the change for this year, but the corporation that bought them out 5 years ago, said they MUST go on the corporate health insurance, despite it being more expensive than the rate DH's bosses negotiated with a different company. We are NOT happy.

We've got a number of CIGNA PPO plans and a Empire BlueCross BlueShield PPO plan to choose between. I need to sit with all the plan information, call all our Drs. and see what they take etc. Just wondered if anyone had any personal experience..

Thanks.

[maestramommy]

Right now we have Blue Cross Blue Shield PPO plus. For the most part we like it. We used to have Cigna POS with Dh's old company in CA. What we liked about that was that there was only the premium and the copay. No deductible, no coinsurance. With our current plan with BCBS we have a 10% coinsurance as well as a deductible. Apart from the extra money we have to pay out of pocket, it's a hassle from the paperwork standpoint. But the coverage (what is covered, what isn't) seems to be about the same.

However, I will say that the entire time I was on Dh's insurance with Cigna I hated how disorganized they seemed to be. They couldn't seem to coordinate with my providers when it came to billing. And whenever I called to inquire about it, it took FOREVER to get a live person, and then they couldn't answer my questions. It would take weeks of back and forthing between my providers medical group and the insurance company to straighten things out.

Also, one last thing about Cigna. With Dh's company they offered HMO, PPO, and POS. As far as network goes, there didn't seem to be any advantage to any one plan. It's not like PPO had a larger network than HMO or POS, just a completely different network. All of our providers were within the HMO network, so we went with the POS plan as a hedge against a possible future provider that might not be in network. PPO cost a lot more, but wasn't any better in their coverage.

[Momof3Labs]

DH has CIGNA PPO; it's my secondary and primary for the rest of my family. I've been pretty impressed with their accuracy of claim processing, and the bills we've gotten (we have 10% coinsurance in-network) are pretty small after the adjustments and insurance payments. However, on the rare occasions when they have messed up, it has taken a fair amount of effort to square things away. The good news, however, is that everything was eventually fixed.

[♥ms.pacman♥]

we have a blue cross blue shield PPO and i must say it's probably the best the best health insurance i've ever had. it covers tons of things like physical therapy sessions, childbirth classes, you name it. i don't think i've ever had to even pay a copay at my OB visits...everything was covered. i've had it for over a year now and absolutely no complaints whatsoever.

[Momof3Labs]

we have a blue cross blue shield PPO and i must say it's probably the best the best health insurance i've ever had. it covers tons of things like physical therapy sessions, childbirth classes, you name it. i don't think i've ever had to even pay a copay at my OB visits...everything was covered. i've had it for over a year now and absolutely no complaints whatsoever.

Note that all of this is specific to your employer's plan. Not everyone with BCBS PPO will have the same coverage, copays, etc.

[michellerw]

I left the Empire PPO for the Cigna OAP when I switched jobs a year ago. I'm sure some of it is just the insurance each company (old company was a 1200+ employee nonprofit, new company is a 500 person software company), but Empire was vastly superior, our premiums and copays were lower, and the network was larger.

[egoldber]

Well, it's a different state, but we have had Cigna twice now (DH's orginal job here and our current federal plan is Cigna in disguise). We have had no issues with them in terms of processing, most things handled correctly, easy to fix.

Our BCBS PPO was a NIGHTMARE. I cannot even describe how horrible they were to us. They blatantly lied to try and get out of paying claims, they would randomly "drop coverage" on the kids, etc. It was terrible.

I will not have BCBS again unless I truly have no other option.

[MelissaTC]

We have had Cigna PPO through IBM for 4 years now and all has been well.

[DebbieJ]

He's not in the union? Motion Picture Industry Pension & Health Plan is the best!

[niccig]

Thanks everyone. I'll have to look at each plan, see which Dr. is in the network.

It looks like the Empire Blue Cross isn't a real PPO. It doesn't allow out of network care. It is an Exclusive Provider Organization (EPO) and not a Preferred Provider Organisation (PPO). The paperwork says it's like an HMO that you have to see in network proviers only, but unlike an HMO you don't have to have a primary care physician or get referrals to see specialists.

I need to wait until we see the list of providers and see if our Drs. are in network. I am not changing endocrinologist or pediatrician.

Debbie - DH's work isn't union. Few of the trailer companies are union, most are not. Friends have motion picture health coverage and I agree it's great.

We also have to start to pay our premiums. I know we've been very lucky that the company paid 100% for us for so long.

We also have a lot of choice. Some plans have higher monthly premium but less deductible and more is covered eg. 90% of In-Network Surgeons. Others have higher deductible, less monthly and less covered eg. 80% In-Network Surgeons. And the EPO Plan has no deductible, and 100% after copays which are $15-$25. But I have to wonder if it's more difficult to get authorization for procedures.

We are all healthy. DS has only been to the Dr. for his well visit all year. I have thyroid condition, but I only see the endocrinologist 3 times a year now and it's just a blood test, adjust medicine. DH is healthy, but his Dad has LOTS of health problems - diabetes, heart conditions, a condition that gives him a tremor. I'm nagging DH to take better care of himself. Who knows what will happen with that in the future, but I do think it's a ways off.

It's just confusing...

[AnnieW625]

We had Blue Cross PPO through our employer State of CA so it was the CalPers plan and it was a freaking rip off since it was only an 80%/20% plan in 2006. We had to meet deductables each year but never did which I never quite understood. I paid $975 more for DD's birth than I would have had I had the HMO insurance, she would been a $25 hospital co pay (still mad at HMO book for not listing OBGYN in our book when he should've been). I had some billing issues with Blue Cross and did get them settled, but still prefer the HMO alternative. I have never been picky about drs. since we moved here, just always been lucky and found someone I liked so the HMO worked for me, but I do understand it might not work for all. Good luck with your choice.

[maestramommy]

Nicci, I just remembered my preggo sis has/had Blue Cross PPO (in SoCal), and it SUCKS. Maybe because she bought it privately. Apparently none of her current providers will accept it anymore because of all the restrictions. Not sure what they are, but she is ready to dump it. Hers was an 80/20 plan as well, and she ended up paying so much out of pocket.

[niccig]

Thanks Melinda, Annie. You do have to be careful as you may never met your deductible and have to pay for EVERYTHING out of pocket...it is such a rip off.

I think it'll come down to who has our Drs. in network. This year is different as there are 4 plans to choose from, so we have to weigh up deductible/coverage/premium. Previous years we didn't choose as they paid for us. I'll compare our old plan with the new ones for coverage, but what I don't know is how difficult is each company to work with.

[AnnieW625]

I had Blue Sheild Access Plus HMO for a couple of years after the PPO and had no issues with it at all. It almost sounds like the EPO you discribed. Again good luck.

[daniele_ut]

I just changed jobs and the company that I am now working for uses Blue Cross EPO. I was a little concerned about not having out of network options, but I looked at the network and it is huge. It pretty much covers every hospital in our metro area and all of our docs accept it. Our company has offices in 14 cities across the country, so they wanted something they could use nationwide.

Our old insurance was really comprehensive and the company was self insured, but it had a $300 a month premium. Our new insurance will have no out of pocket premiums for us, which is a bonus. We won't be covered by BCBS until December 1st, so I can't comment on how easy they are to deal with, but my co-workers have nothing really bad to say.